Random thoughts from a few cantankerous American physicians. All contributors are board certified. Various specialties are represented here. I do not know where this will lead but hope it will at least be an enjoyable read. All of the names mentioned in this blog are pseudonyms, the ages have been changed, and in half the cases the gender as well. All photographs are published with patient consent or are digitally altered to preserve anonymity. Trust us, we're doctors.

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Friday, August 15, 2008

I have some questions for anyone who cares to speculate. Let's assume our impromptu and very unscientific poll you see on the right sidebar is horribly inaccurate and is up to 25% off in either direction. Let's say only 39% of Board-Certified Emergency Physicians are going to quit before putting in a traditional 20 years. If you are interested do a little research into ER usage and trends in America, and into ER closures. You tell me what it means (hint above).

20 comments:

Although I am not engaged in medical, scientific, if in the right direction, which may be the experience of doctors, scientists or the experience, more experience, the probability guess is around 80 percent! Not this what it represented.

1. Were not ER doctors2. Were not doctors3. Were not in the ER long enough to know what lies in store4. Were emergency medicine wannabes and cannot possibly think why they would want to quit5. Thought that they had to vote to see the results (some polls have that feature)6. Did it for cheap thrills

Actually, I didn't vote for this one, though, if I have my way, I wouldn't mind doing a EM/IM residency. Although these are not really on offer to IMGs. But blogs like yours make me think again..

it means we are in deep, dark yogurt.no good, old, cynical, EXPERIENCED, cranky docs and nurses to take care of us when the shit hits the fan.so... make that pact with your buddies.

can't wait for the oldfart to critique the state of the system!!!

one quick little item to get your blood boilin'one of our great er docs ( doing it forever ; famous for doing her 10 hour shifts in gorgeous high heels and bright red lipstick) gets the proverbial dump:complicated post op f-up.. bowel surgery with tubes/drains, comes in septic.had surgery at hospital 20 miles north ; surgeon & primary also up there. obviously needs admission and things sorted out.why did she come to OUR er?well, it seems as if when she started to turn sour and called doc, HE said to go to our er ( closer by 10 minutes, ahem).when our er doc called surgeon to get a bit of a history for this lol... well, er doc kinda, sorta, maybe mentioned that this was unfortunate , like maybe a DUMP, because in the best case scenario the pt. would be returning to the facility that did her pre-hospital care/surgery/post-op care..guess what???surgeon had a hissy fit when he heard the word dump.. not even in an EMTALA way..( we are not that kind of group), just in a " why in the heck" way..so of course our er director gets a call from the other hospital the next day. so said surgeon can cover his ass... we all know it was just wrong to put this lady through all the hoops of getting admitted to our place through our surgical service/ hospitalist program. but surgeon is just an ass and now needs to cover his tracks.lol does ok.. er doc in high heels just can't believe how stupid it all is.er doc ok.. she's married to director.

idealistic students come to er because it is exciting and noble and challenging.i think the problem now is the bureaucratic bullpuckythat makes it slowly morph into a bad dream.those of us in the field know.. the common sense is gone.. replaced with middle management sludge.

I've been thinking about radiology. So far as I can tell, there's very little actual work involved. Looking at films, far from actual patients, for obscure tidbits of this and that? Not so bad.

We send all our films to Australia during the night. I'm sure they arrive in some smoke filled room with lots of big leather chairs, humidors, fine Barbados and St Kitts Rum, with lots of exotic women wearing nothing except nipples serving delicious cuts of extra rare Kobe Beef all while waiting for the random film to arrive electronically.

See, I don't understand why everyone thinks radiology is so boring b/c of the lack of patient contact. What about an obnoxious drug seeking patient makes the ER so great? I did switch from EM to radiology and it was the best decision i ever made. I get to be involved in all the great cases but after i dictate my findings i'm done... No rounding/no pages..i move on to the next case. In an average day I read CT, MRI, US, nuclear medicine, plain film and do 5-6 procedures(I actually do more procedures in radiology than EM). I work very few nights or weekends and i get 12 weeks vacation. Seriously, this is the GREATEST field in medicine and 99% of my colleagues agree. Nobody is leaving radiology and we don't have polls on how long we'll "stick it out". Is radiology perfect...of course not. We have our battles(turf battles, reimbursement, outsourcing) but i would still do this job for half the salary(dont tell the government that). It is that good.

okoki give up.drug seeking patients do suck big time.it's just the sour grape thing.you nailed it. you got the great set up.can't i bitch a little. give you some crap.so i can feel a teensy bit better??i don't mind the drug seekers so much.what gets my goat is the p.o. contrast ( yummy berry flavor) everyone is chuggin' down... just to make it easier on YOU guys.love ya.

Lily,Sorry to get on my soap box but i feel like sometimes i need to defend radiology. Like EM, we are often the whipping boys of the hospital and explaining ourselves gets old. Most other speciaties think we don't work hard enough and even seem suprised that we are in house after 3pm! The truth of it is most radiologist will average 150 studies per day and work 60 hours/week and as imaging gets faster and more accesible this number will only go up. Just wait until MRI stroke protocol becomes the norm...Anyway, no hard feelings, okay.Signed,Your friendly neighborhood radiologist

love my radiology bruthas. actually i'm quite envious of you as you did your time in the trenches and now can do your job, most times, from wherever you please. how many years would they make me do to do rads? three? four? glad i did EM but enuffs enuff.

Come on guys.. Radiology is way too important a department for the purpose of evolution as well. I wouldn't dare raise my voice against a field of science where they have the potential for creating the next Mr. Fantastic or The Incredible Hulk. I mean, let's face it: mutants are way cooler than us 'normal people'. In fact I find myself faking headaches and head trauma just so that I can visit my friendly neighbourhood radiologist to get a CT. And a good radiologist knows how important a role he plays in making sure new genes enter our gene pool, while all the other doctors nurture and promote the presence of an organism which had been rejected by nature itself. Criminal.

So enough with the Radiology bashing! I'm sure you won't be seen arguing tomorrow, when Dr. Anonymous grows a tentacle on his forehead and drains the life forces out of your gonads. Bring on the gamma radiation, yeah! :P